Mid-term durability of the Trifecta bioprosthesis for aortic valve replacement
| Autor: | Thierry Langanay, Hervé Corbineau, Bernard Lelong, Erwan Flecher, Alain Leguerrier, Vito G. Ruggieri, Amedeo Anselmi, Jean-Philippe Verhoye |
|---|---|
| Přispěvatelé: | Laboratoire Traitement du Signal et de l'Image (LTSI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], CHU Pontchaillou [Rennes], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male Reoperation medicine.medical_specialty Average duration Time Factors [SDV]Life Sciences [q-bio] Hemodynamics Kaplan-Meier Estimate 030204 cardiovascular system & hematology outcomes law.invention 03 medical and health sciences 0302 clinical medicine Aortic valve replacement [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system law Internal medicine trifecta medicine Cardiopulmonary bypass Endocarditis Humans In patient aortic valve replacement Aged Retrospective Studies Bioprosthesis Absolute number business.industry Operative mortality medicine.disease 3. Good health Surgery Prosthesis Failure 030228 respiratory system Echocardiography Aortic Valve Heart Valve Prosthesis Cardiology durability Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Thoracic and Cardiovascular Surgery Journal of Thoracic and Cardiovascular Surgery, Elsevier, 2017, 153 (1), pp.21-28.e1. ⟨10.1016/j.jtcvs.2016.07.080⟩ Journal of Thoracic and Cardiovascular Surgery, 2017, 153 (1), pp.21-28.e1. ⟨10.1016/j.jtcvs.2016.07.080⟩ |
| ISSN: | 0022-5223 |
| Popis: | International audience; Objective To clarify the mid-term durability of the Trifecta bioprosthesis for aortic valve replacement (AVR). Methods We retrospectively analyzed the prospectively collected data of 824 consecutive implants of the Trifecta valve at a single institution. A 100% complete follow-up was available (average duration, 2.2 ± 1.3 years; range, 0.03-6.9 years; 1747.6 patient-years). Echocardiography data at discharge were recorded prospectively. Results Operative mortality was 3.8%; 2.7% in patients receiving isolated AVR. There were 5 valve-related early reoperations, including 1 for infective prosthetic endocarditis and 4 for nonstructural valve dysfunction. The global rate of severe patient–prosthesis mismatch was 1.26%. Overall 5-year survival was 74.9%, and freedom from valve-related death was 97.8%. The majority of deaths attributed to the valve were due to unknown causes. We observed 6 SVD events at 3.4 ± 1.6 years after surgery. At 5 years, the actuarial freedom from SVD was 98% ± 0.9% (n = 6), freedom from reintervention for SVD was 98% ± 0.9% (n = 5, including 2 transcatheter valve-in-valve), and freedom from open reoperation for SVD was 98.9% ± 0.6%. The 5-year freedom from prosthetic endocarditis was 97.7% ± 0.7% (n = 12, 6 requiring reoperation). There was 1 case of late NSVD (5-year freedom, 99.8% ± 0.2%). Freedom from hemorrhagic events was 98.6% ± 0.5% (86% occurring in patients on anticoagulants); there were no thromboembolic events at follow-up. Conclusions The Trifecta bioprosthesis is a reliable device for AVR. We confirm excellent immediate hemodynamic properties and a very low rate of patient–prosthesis mismatch. The absolute number of SVD cases observed remains limited; nevertheless, their timing, pathological characteristics, and clinical presentation mandate continued follow-up. |
| Databáze: | OpenAIRE |
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